﻿@model Adams.Public.DataTransfer.Web.Areas.Membership.Profile.General.PageLoad
@{
    Layout = "~/Views/Shared/_MembershipLayout.cshtml";
}
@section Head{
}
<h1>My Information</h1>
<div id="form">
    <div id="notif">
    </div>
    <div class="form-left">
        <div class="form-text">
            <span class="required">*</span>First Name:</div>
        <div class="form-right">
            <input type="text" class="input" id="FirstName" value="@Model.Member.FirstName" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            <span class="required">*</span>Last Name:</div>
        <div class="form-right">
            <input type="text" class="input" id="LastName" value="@Model.Member.LastName" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            <span class="required">*</span>Street:</div>
        <div class="form-right">
            <input type="text" class="input" id="Street" value="@Model.Member.Street" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            Street2:</div>
        <div class="form-right">
            <input type="text" class="input" id="Street2" value="@Model.Member.Street2" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            <span class="required">*</span>City:</div>
        <div class="form-right">
            <input type="text" class="input" id="City" value="@Model.Member.City" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            <span class="required">*</span>State:</div>
        <div class="form-right">
            <select id="State" class="option">
        <option value="">Choose State...</option>
        <option value="AL">Alabama</option>
        <option value="AK">Alaska</option>
        <option value="AZ">Arizona</option>
        <option value="AR">Arkansas</option>
        <option value="CA">California</option>
        <option value="CO">Colorado</option>
        <option value="CT">Connecticut</option>
        <option value="DE">Delaware</option>
        <option value="DC">District of Columbia</option>
        <option value="FL">Florida</option>
        <option value="GA">Georgia</option>
        <option value="HI">Hawaii</option>
        <option value="ID">Idaho</option>
        <option value="IL">Illinois</option>
        <option value="IN">Indiana</option>
        <option value="IA">Iowa</option>
        <option value="KS">Kansas</option>
        <option value="KY">Kentucky</option>
        <option value="LA">Louisiana</option>
        <option value="ME">Maine</option>
        <option value="MD">Maryland</option>
        <option value="MA">Massachusetts</option>
        <option value="MI">Michigan</option>
        <option value="MN">Minnesota</option>
        <option value="MS">Mississippi</option>
        <option value="MO">Missouri</option>
        <option value="MT">Montana</option>
        <option value="NE">Nebraska</option>
        <option value="NV">Nevada</option>
        <option value="NH">New Hampshire</option>
        <option value="NJ">New Jersey</option>
        <option value="NM">New Mexico</option>
        <option value="NY">New York</option>
        <option value="NC">North Carolina</option>
        <option value="ND">North Dakota</option>
        <option value="OH">Ohio</option>
        <option value="OK">Oklahoma</option>
        <option value="OR">Oregon</option>
        <option value="PA">Pennsylvania</option>
        <option value="RI">Rhode Island</option>
        <option value="SC">South Carolina</option>
        <option value="SD">South Dakota</option>
        <option value="TN">Tennessee</option>
        <option value="TX">Texas</option>
        <option value="UT">Utah</option>
        <option value="VT">Vermont</option>
        <option value="VA">Virginia</option>
        <option value="WA">Washington</option>
        <option value="WV">West Virginia</option>
        <option value="WI">Wisconsin</option>
        <option value="WY">Wyoming</option>
    </select>
    <input type="hidden" id="statedefault" value="@Model.Member.State" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            <span class="required">*</span>ZipCode:</div>
        <div class="form-right">
            <input type="text" class="input" id="ZipCode" value="@Model.Member.ZipCode" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            <span class="required">*</span>Phone:</div>
        <div class="form-right">
            <input type="text" class="input" id="Phone" value="@Model.Member.Phone" />
        </div>
    </div>
    <div class="form-left">
        <div class="form-text">
            &nbsp;</div>
        <div class="form-right">
            <a href="#">
                <img src="/Content/Images/submit.jpg" alt="Submit" border="0" id="submit" /></a></div>
    </div>
    <div class="clear">
    </div>
</div>
@section Scripts {
    <script src="/Areas/Membership/Scripts/Profile/general.js" type="text/javascript"></script>
}
